Objectives Mannose -binding lectin(MBL)is active in the innate immune defense against micro organisms.In this study,we determined whether vulvar vestibulitis syn-drome,a disorder of unknown etiolog y,was associated with an altered distribution of MBL alleles.Study design Buccal swabs were obtained from women with v ulvar vestibulitis syndrome in New York(62)and from 2cities in Sweden(60),as well as control women in New York(48)and Sweden(51).DNA was tested for a single nucleotide polymorphism at codon 54in exon I by p olymerase chain reaction,endonuclease digestion,and gel electrophoresis.Blood samples were also obtained fro m the New York women and tested by ELISA for plasma MBL concentra-tions.The relationships between genotype,allele frequen-cies,blood MBL levels,and diagnosiswere analyzed by Fisher exact test and oneway analysis of variance.Results The variant MBL allele,MBLB,was detected in35.5%and 26.7%of vulvar vestibulit is patients from New York and Sweden,respectively.Only 12.5%of New York controls(P =.007)and 9.8%of Swedish controls(P =.01)were MBL2-positive.All women,with one exception,who were positive for MBLB were MBLA /MBLB heterozygotes.Women who carried MBLB had almost a 10-fold reduction in median plasma MBL con-centrations(278ng /mL),as opposed to women who were MBLA homozygotes(1980ng /mL)(P<.0001).Conclusion MBLB carriage and reduced plasma MBL levels are more common in women with v ulvar vestibulitis syndrome than in control patients,a nd may contribute to symptomatology in a subset of patien ts.
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